Dr Kate Barnett OAM
When we think of reform in the Australian aged care system, we think of the many formal inquiries, reviews and most recently, the Royal Commission into Aged Care Quality and Safety. This is the formal face of reform, originating within the aged care system, and with multiple stakeholders (in particular, governments, consumers, carers, service providers and peak bodies) as its audience.
Rarely is technology seen as a part of this ongoing reform process, probably because it has not been central to the traditional design and delivery of care. It is also likely to reflect a lack of research evidence about Return on Investment in technology in aged care. Analysis of the major reviews of the past decade or so finds them lacking a technology lens. The first Technology roadmap for aged care [1] was designed to complement the 2016 Aged Care Sector Committee’s Aged care roadmap [2], which had not identified a role for technology. The Royal Commission into Aged Care Quality and Safety, however, did make a number of recommendations regarding technology-enhanced care. [3]
However, in recent years, the boundaries between the care and technology sectors have been softening. [1] The COVID-19 pandemic played a part in pushing health and aged care providers to make use of technology supporting virtual care, as have the many partnerships between ‘Big Tech’ (e.g., Apple, Google) and health and aged care organisations. In addition, there is now significant cross-over between the aged care sector and technology designed to make lifestyles easier (especially Smart Homes and voice-activated technologies). There is also cross-over with technology that is health-promoting and places the consumer as a collaborator with care providers in managing their health (e.g., Smart Watches, Fitbits, and a plethora of health-supporting Apps). Voice Activation technology overcomes the need for digital literacy and for manual dexterity – a significant advantage for many very old people – and can be integrated into home care delivery to support independent living, as has been ably demonstrated by Feros Care. [4]
Smartphone ownership now involves more than 90% of Australians, with older people continuously increasing their engagement with this technology. Importantly, Smartphone technologies include sensors (accelerometer, gyroscope, GPS) that can generate data obtained in ‘real time’, and if linked to appropriately designed Apps, can provide feedback to the individual about their health-related status, and be utilised by care providers. [5, 6]
Consumer expectations are changing with increased demands for immediacy and for personalisation of services (e.g., Uber). Portals are becoming increasingly widespread, drawing on software and online platforms that can connect an individual to a specific service, and are now part of the aged care ecosystem. A well-known example is Mable which enables a potential consumer to search for an independent support provider and connect directly with them, negotiating how their service will be delivered and tailored to individual need.
It is important to recognise that many technologies are invented without the purpose of providing care or support to older people, but have that outcome and are, therefore, highly relevant to the aged care sector, especially the home care system. They also normalise health promotion and support technologies, avoiding the stigma associated with many Assistive Technologies. These technologies are slowly and surely disrupting the care system as we know it, particularly the home care service sector, and should be recognised as part of the reform process.
*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.